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The Obamacare Hydra

The Hydra was a mythical swamp beast whose multiple heads grew back after being severed. Obamacare is a real Washington monster whose countless hidden bureaucracies keep sprouting forth even after they're rooted out. As soon as combatants lop off one of the law's unconstitutional agencies, another takes its place.

On Thursday, as the behemoth federal health care law marked its second anniversary, House Republicans repealed the infamous Independent Payment Advisory Board. The mother of all death panels, IPAB would have unprecedented authority over health care spending through a rogue board of 15 Medicare spending czars. The House repeal has a snowball's chance in hell of surviving the Senate. But IPAB's legality is being challenged in federal court by the conservative Arizona-based Goldwater Institute. And the more the public knows about these freedom-usurping, taxpayer-soaking institutions buried in the health care law the less they like it.

Seven House Democrats crossed the aisle to vote for the GOP majority rollback. Analysts on both sides of the political aisle have decried IPAB's complete lack of accountability and insulation from judicial review. Critical decisions about public and private health insurance payment rates would be freed from the normal administrative rules process - public notice, public comment, public review — that governs every other federal commission in existence. Rep. Todd Akin, R-Mo., summed up bipartisan opposition: "IPAB embodies the very thing Americans fear most about ObamaCare — unaccountable Washington bureaucrats meeting behind closed doors to make unilateral decisions that should be made by patients and their doctors."

The problem with piecemeal repeal is that for every old IPAB, there's a new, multibillion-dollar bureaucracy waiting in the Obamacare wings. Senate Republicans and fellow medical doctors Tom Coburn and John Barrasso point to a $10 billion entity called the "Innovation Center" that "would test innovative payment and service delivery models to reduce program expenditures under Medicare, Medicaid and the State Children's Health Insurance Program (CHIP)."

According to a new Congressional Research Service analysis of this little known office to be operated by the Centers for Medicare and Medicaid Services, there would be "no administrative or judicial review" of the director's payment experiments.

Coburn and Barrasso explain that "(t)his means that the administrator of CMS is the sole individual in the entire federal government with the power to decide whether or not models tested negatively impact seniors' quality of care and meet the financial requirements spelled out in law."

This "innovation" super-czar would be allowed to tinker behind closed doors — and then impose whatever experiments the "innovation center" chooses without any checks or balances on the methods or results. Moreover, at least two other sub-offices within CMS (subject to normal open meetings and open records rules) have already been tasked with researching payment and delivery models. Health care blogger Tevi Troy at NationalReview.com warns: "The 'innovation' center appears to be one more way in which the health-care law is going to interfere with the practice of medicine, and one that physicians should start paying more attention to."

It's not just physicians who need to pay attention. Every taxpayer has a stake. At the end of the month, this shadowy agency will start doling out $1 billion in grants to payment experiment groups and data-tracking system builders. Sounds like yet another pipeline for political payoffs and Chicago-style boodle that will result in less patient autonomy, fewer health care choices, more government intrusion and lower-quality care.